title: Prevalence of CYP2C19 polymorphisms in the Lebanese population.
abstract: Clopidogrel is one of the most commonly prescribed drugs, as its combination with low-dose aspirin is the recommended oral anti-platelet therapy, to prevent ischaemic events following coronary syndromes or stent placement. Numerous recent studies have shown that polymorphisms in the gene encoding the cytochrome P450 (CYP450) 2C19 enzyme (CYP2C19) contribute to variability in response to clopidogrel; patients with certain common genetic variants of CYP2C19 (2, 3) have a reduced metabolism of clopidogrel and have a higher rate of cardiovascular events or stent thrombosis compared to patients with the CYP2C19 (1) allele. CYP2C19 2 is most common in Caucasians, Africans and Asians while CYP2C19 3 has been found mostly in Asians. Since the prevalence of these variants in the Lebanese population has not yet been reported, our aim was to determine the genotypes of CYP2C19 in our population. CYP2C19 (1/2/3) variants were assessed by Polymerase Chain Reaction-Restriction Length Polymorphism (PCR-RFLP) assays in a representative sample of 161 unrelated healthy Lebanese volunteers. The allele frequencies of CYP2C19 2 and 3 were 0.13 and 0.03. Carriers of the CYP2C19 2 or 3 represented 24.2% of the subjects. Our data show no significant difference in the frequency of CYP2C19 allelic variants when compared to Caucasian populations and demonstrate that the application of the recent FDA recommendations would also be beneficial in Lebanon, allowing physicians to identify patients at high risk for atherothrombotic events, and eventually advising them to consider other antiplatelet medications or alternative dosing strategies in poor metabolizers.
authors.affiliation: Department of Clinical Laboratory, Saint George Hospital University Medical Center, Achrafieh Beirut 1100, 2807 Beirut, Lebanon. idjureidini@stgeorgehospital.org
authors.forename: Isabelle
authors.initials: I
authors.lastname: Djaffar Jureidini
authors.forename: Nabil
authors.initials: N
authors.lastname: Chamseddine
authors.forename: Sose
authors.initials: S
authors.lastname: Keleshian
authors.forename: Rania
authors.initials: R
authors.lastname: Naoufal
authors.forename: Laila
authors.initials: L
authors.lastname: Zahed
authors.forename: Noha
authors.initials: N
authors.lastname: Hakime
mesh_terms: D000293:Adolescent; D000328:Adult; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics*; D065731:Cytochrome P-450 CYP2C19; D005260:Female; D005787:Gene Frequency / Q000235:genetics; D005828:Genetics, Population; D005838:Genotype; D006801:Humans; D007861:Lebanon; D008297:Male; D011110:Polymorphism, Genetic; D015995:Prevalence; D055815:Young Adult
chemical_list: D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19